Employee Health Benefits
The Consolidated Appropriations Act (CAA) of 2020 will oversee employers and others that buy health benefits. It seems several employers are not informed about these laws effecting their health benefits for employees.
Both political parties support the CAA as well as the current and previous administrations. Employers must ensure value from providers and vendors, and prohibits hidden terms that negatively affects employers and their employees.
Compliance includes the following rules and responsibilities:
-No more withheld claims data other than privacy-protected data. Health plans, third party administrators, consultants, brokers, and pharmacy benefits managers will need to become more transparent
-Compulsory reporting of pharmacy and prescription drug prices.
-Disclosure of all compensation from all service providers. Agreements between brokers and plans or PBMs and pharma companies must be transparent.
Employers, rather than, brokers or consultants must show to federal officials that their health programs are affordable, high quality, and meet other requirements. They must reveal these details to their employees.
Companies and employees will soon know the actual health costs, including details from health care providers, vendors, service providers, and others. Employers will need to demand accountability of those involved in their health programs.
These organizations depend on their consultants to manage their health plans. It is not the vendors but instead the employers that have a fiduciary role in this law and will need to comply regardless of the vendors’ actions.
The Department of Labor, has begun scrutiny, and requested documentation from some companies. It seems that none are compliant with the CAA so far.
Employers will need to analyze and demand more of their health plans to demonstrate high quality and value for money.
More than 500 people a day die in the U.S. from preventable medical errors. The wrong hospital is an avoidable disaster at any cost. These employers will become fiduciaries for their employees and will need to provide them with mechanisms to make better health choices.
Please watch this space.
Our Editorial Note: Above is our brief summary of an article from Forbes. You may need a subscription to view the article in its entirety. Contact us if you would like to learn more about regenerative medicine and how it may help patients with their medical conditions.